POS0080-HPR LONG-TERM EFFECTIVENESS OF A LIFESTYLE PROGRAM FOR RHEUMATOID ARTHRITIS: ONE-YEAR FOLLOW-UP OF THE “PLANTS FOR JOINTS” RANDOMIZED CLINICAL TRIAL
Authors: C. Wagenaar, W. Walrabenstein, M. Van der Leeden, F. Turkstra, J. Twisk, M. Boers, H. Van Middendorp, P. Weijs, D. Van Schaardenburg
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The 16-week Plants for Joints (PFJ) multidisciplinary lifestyle program, based on a whole-food plant-based diet, physical activity, and stress management, significantly reduced 28-joint Disease Activity Score (DAS28) score compared to usual care in patients with rheumatoid arthritis (RA).<sup>[1,2]</sup> <h3>Objectives</h3> To determine the long-term effectiveness of the PFJ lifestyle program on disease activity in patients with RA. <h3>Methods</h3> In the PFJ assessor-blind randomized clinical trial, patients with RA and a DAS28 score ≥ 2.6 and ≤ 5.1 were randomized to receive the PFJ program in addition to usual care, or the control group which received usual care. After this 16-week period the control group also received the PFJ program. After completion of the PFJ program all participants were followed-up for one year with biannual visits and 6 adherence-promoting webinars. If participants had a DAS28 score &lt;2.6 they were instructed to taper anti-rheumatic medication following a pre-specified protocol. Medication changes were assessed at one year as an "increase," "stable," or "decrease" compared to baseline by an independent committee. Secondary outcomes included anthropometric and metabolic markers. A paired sample T-Test between 1-year follow-up and start of intervention was performed. <h3>Results</h3> Of 77 participants who completed the initial 16-week clinical trial 92% were female with a mean (SD) age of 55 (12) and body mass index of 26 (4) kg/m² at baseline. The 65 (84%) participants who completed the one-year follow-up had a greater average change in DAS28 score (–0.9 vs. –0.05) compared to non-completers. In the year after completing the PFJ program the DAS28 score continued to improve slightly whereby a mean 1.01-point difference was observed after one year for the completed cases compared to baseline values (95% CI 0.76 to 1.26; <i>p</i> &lt; 0.001) (Figure 1). All components of the DAS28 improved significantly compared to before the program (Table 1). Significant improvements were found in both the seropositive and seronegative subgroups. Of the 61 participants using anti-rheumatic medication at baseline, 27 (44%) were able to decrease the dosage or stop one or more medications. Antirheumatic medication was stable for 16 participants, and increased for 13, of which 5 newly started using medication. 45 participants (58%) had improved DAS28 scores (of which 20 had a DAS28 &lt;2.6) with stable or less medication compared to baseline. After the 1-year follow-up period there was no longer a significant difference in weight or HbA1c although LDL cholesterol remained significantly lower compared to baseline. <h3>Conclusion</h3> The PFJ lifestyle program significantly decreased disease activity in patients with RA and its effects were sustained until one year after program completion, with slightly less anti-rheumatic medication. Metabolic benefits found after the lifestyle intervention were only partially sustained possibly indicating attenuated adherence to the lifestyle program in the 1-year follow-up. <h3>References</h3> [1]Walrabenstein, Trials 2021 [2]Walrabenstein, Rheumatology 2023 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.